Application for Membership Midwest Division TCA
Name ________________________________________________________________ TCA # ____________________
Address ______________________________________________________________ Phone# ___________________
City ____________________________________________ State ___________ Zip Code _________________
E-Mail Address _______________________________ (Your e-mail address will be used for MWD information only.)
Name of Person Who Recommended You.
Regular MWD Membership
The Regular Membership covers the cost of yearly MWD dues of $15.00. The member must pay a $2.00 door fee at each meet except the March ($5), September ($5), June, and Christmas ($5) meets.
Annual MWD Membership
The Annual Membership covers MWD yearly dues and door fees for all MWD meets, a separate sign in sheet at meets, and automatic pre-registration for the March and September Big Meets. If paid by the July 1st deadline, Annual Members will receive a specially designed commemorative billboard.
Family MWD Membership
Family Membership is $5.00 annually and includes admission to each meet without additional door fees. Any member of the family without a family membership who attends a meet will pay a door fee for each regular monthly MWD meet attended.
Annual Membership $35.00 ___________
Regular Membership $15.00
Family Membership
Spouse (Name) __________________________________________________________ $ 5.00
Children ________________________________________________________________ $ 5.00 Ea. ___________
(Ages 10 through 17 - Please List Names And Ages) Total $
NEW MEMBERSHIP CARDS WILL BE SENT TO YOU.
Make all checks or money orders payable to: Midwest Division TCA
Mail To: Mary Reich, Business Manager
2629 W. 121st Place
Blue Island, IL 60406
708-489-2957
